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College of Denturists
of
British Columbia
Complete Denture Evaluation
Clinical Criteria
Version: 072016
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Clinical Criteria
Clinical Appearance
0
1
Clinical crowns of teeth not exposed or
interproximal papillae poorly defined and
shaped
Clinical crowns exposed to crown line and
well shaped interproximal papillae
Extensions
Any buccal or labial flange under extended
or overextended greater than 3mm or any
frenum impingement
All flanges finished to mucogingival border
and
no frenum impingement
Retention and stability
Upper denture displaces on maximum
opening
or no resistance to physical removal and
lower denture unstable during functional
movements
Denture remains in place on maximum
opening
and resists physical removal and lower
denture stable relative to anatomical
structures
Central fossa location
Centre of lower posterior teeth is lingual or
labial of crest of residual ridge by more
than 2mm
Plane of occlusion
Not perpendicular to mid sagittal plane or
no curve of Wilson/curve of Spee or
inconsistent with ala tragus plane or
occlusal table exceeds mid height of tongue
Centre of mandibular posteriors lies directly
over the crest of the residual ridge
Perpendicular to mid sagittal plane and
curve of Wilson/curve of Spee present and
parallel to ala tragus plane and occlusal
table approximates 50% of the retro molar
pads
Examiner’s Initials _________
Page 2
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Section 1
Examiners: Use this section
if treatment plan indicates
IOD of 4 mm or less.
If the proposed interocclusal distance is greater than 4mm,
use Section 2.
Examiner’s Initials _________
Page 3
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Clinical Criteria
Vertical Dimension of Occlusion and Relation:
This section will test the candidate’s abilities and understanding of vertical jaw relationships. To ensure
consistency, please follow the suggested procedures to determine vertical dimension of occlusion and
vertical dimension of relation.
Centric Occlusion:
For the purposes of this exam, centric occlusion is defined as simultaneous bilateral contact of the
posterior occluding surfaces at which the condyle is in its most retruded position from which lateral
excursions can be made. There must be a cusp fossa relationship, i.e., full intercuspation with buccal
overjet involving at least five contacts per side on at least three teeth per side.
Centric occlusion should be verified prior to interocclusal distance to prevent any
proprioceptive behaviour as the patient learns the position of centric occlusion in the
dentures, which are the subject of the evaluation.
Table L
0
1
Any premature contact of any tooth
or
contact on one side prior to the other
or
less than 5 contacts per side on less than 3
of the posterior occluding surfaces
or
less than full intercuspation with buccal
overjet
Simultaneous, bilateral contact
of all posterior teeth with full
intercuspation and buccal overjet
with at least 5 contacts per side on 3 or
more posterior occluding surfaces
Examiner’s Initials _________
Page 4
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Clinical Criteria
To determine freeway space complete the following:
1. Place a mark on the patient’s nose and chin.
2. With the patient sitting in a comfortable, upright position, dentures in-situ, have the patient close the
teeth together with light pressure and relax the lips and cheeks. Measure the distance between the two
marks. Complete this step three times, record your findings below, and calculate the average.
1
2
3
Average
_________mm
________mm
________mm
A =________mm
(To calculate average, add 1________ plus 2________ plus 3________ equals Sub Total ________
Sub Total ________ divided by 3 = Average ________ . Write amount on line .)
(A)________mm
MECHANICAL DETERMINATION OF REST
3. Please choose ONE of the following:
Remove the lower denture
or
Leave the lower denture in place.
Examiner’s Initials _________
Page 5
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
4. Instruct the patient to open comfortably wide and slowly close together until the lips lightly touch.
Measure the distance between the two markings. Complete this step three times, record your findings,
and calculate the average.
1
2
3
Average
_________mm
________mm
________mm
B =________mm
5. Instruct the patient to fully wet the lips with the tongue, swallow and relax. Measure the distance
between the markings. Complete this step three times, record your findings, and calculate the average.
1
2
3
Average
_________mm
________mm
_______mm
C=________mm
Add B______ + C______ , then divide by 2 = (D)____________mm
Subtract the averaged measurement of vertical dimension of occlusion (A) from the averaged
measurement of vertical dimension of relation at rest (D)
D_______ - A_______ = E________mm
The average mechanically determined inter-occlusal dimension is (E)________mm
Table M
0
less than 2mm or more than 4mm of
interocclusal distance
1
2-4mm interocclusal distance
Heavy contact of teeth during speech
excessive milling or adjusting (more than
15% of the occluding surfaces have been
removed)
No contact or light contact with appropriate
IOD during speech
less than 15% of the occluding surfaces
have been removed through
milling and or adjusting
Examiner’s Initials _________
Page 6
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Section 2
Examiners: Use this section
if treatment plan indicates
IOD of greater than 4 mm.
Examiner’s Initials _________
Page 7
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Step One:
Determine if Centric Occlusion of Relation is correct in the Candidate’s try-in. Place the upper and lower
try-ins in the patient’s mouth and verify centric occlusion.
Mark the appropriate box in table N
Centric Occlusion of Candidate’s Try-in :
For the purposes of this exam, centric occlusion is defined as simultaneous bilateral contact of the
posterior occluding surfaces at which the condyle is in its most retruded position from which lateral
excursions can be made. There must be a cusp fossa relationship, i.e., full intercuspation with buccal
overjet involving at least five contacts per side on at least three teeth per side.
Centric occlusion must be verified prior to interocclusal distance to prevent any
proprioceptive behaviour as the patient learns the position of centric occlusion in the
dentures which are the subject of the evaluation.
Table N
0
1
Any premature contact of any tooth
or
contact on one side prior to the other
or
less than 5 contacts per side on less than 3 of the
posterior occluding surfaces
or
less than full intercuspation with buccal overjet
Simultaneous, bilateral contact
of all posterior teeth
with
full intercuspation and buccal overjet
with
at least 5 contacts per side on 3 or more
posterior occluding surfaces
Examiner’s Initials _________
Page 8
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Step Two:
Determine the patient’s interocclusal distance with their existing dentures
Vertical Dimension of Occlusion and Relation:
The candidate has proposed an interocclusal distance that is greater than 4 mm. There are valid reasons
for interocclusal distance in excess of normal (3mm+/- 1mm).
 The reasons MUST be noted in the patient record
 The patient record MUST indicate the amount of IOD of the existing dentures.
 If the candidate is opening the vertical dimension of Centric Occlusion more than 3 mm, the
reason MUST be noted in the treatment plan and/or patient record.
Existing Dentures
To determine the vertical dimension of occlusion of the existing dentures, complete the
following:
1. Place a mark on the patient’s nose and chin.
2. With the patient sitting in a comfortable, upright position, both dentures in place, have the patient
close the teeth together with light pressure and relax the lips and cheeks. Measure the distance between
the two marks. Complete this step three times, record your findings below, and calculate the average.
1
2
3
Average
_________mm
________mm
________mm
A =________mm
3. Please choose ONE of the following:
Remove the lower denture
or
Leave the lower denture in place.
** This MUST be the same choice in STEP 9 **
Examiner’s Initials _________
Page 9
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
4. Instruct the patient to open comfortably wide and slowly close together until the lips lightly touch.
Measure the distance between the two markings. Complete this step three times, record your findings,
and calculate the average.
1
2
3
Average
_________mm
________mm
________mm
B =________mm
Calculate average as above. Place on line B
5. Instruct the patient to fully wet the lips with the tongue, swallow and relax. Measure the distance
between the markings. Complete this step three times, record your findings, and calculate the average.
1
2
3
Average
_________mm
________mm
_______mm
C=________mm
Add B______ + C______ , then divide by 2 = (D)____________mm
6. Using the average measurement of vertical dimension of relation, measurement D, subtract the
vertical dimension of occlusion of the patient’s existing dentures, measurement A, and place the result at
E.
D_______ - A_______ = E________mm
The average mechanically determined vertical dimension of occlusion of the patient’s
existing dentures is (E)________mm
Examiner’s Initials _________
Page 10
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Step 3: Determine the amount of IOD with the candidate’s try-in in place
Determine Vertical Dimension of Occlusion of the try-in, complete the following:
7. Place a mark on the patient’s nose and chin.
8. With the patient sitting in a comfortable, upright position, dentures in-situ, have the patient close the
teeth together with light pressure and relax the lips and cheeks. Measure the distance between the two
marks. Complete this step three times, record your findings below, and calculate the average.
1
2
3
Average
_________mm
________mm
________mm
I =________mm
(I)________mm
To determine the Mechanical Vertical Dimension of Rest
9. Please choose ONE of the following:
Remove one denture (preferably the lower)
or
Leave one denture in place (preferably the lower).
** This MUST be the same choice in STEP 3 **
10. Instruct the patient to open comfortably wide and slowly close together until the lips lightly touch.
Measure the distance between the two markings. Complete this step three times, record your findings,
and calculate the average.
1
2
3
Average
_________mm
________mm
________mm
J =________mm
Examiner’s Initials _________
Page 11
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
11. Instruct the patient to fully wet the lips with the tongue, swallow and relax. Measure the distance
between the markings. Complete this step twice and record your findings.
1
2
3
Average
_________mm
________mm
_______mm
K=________mm
Calculate average as above. Place on line K
Add J______ + K______ , then divide by 2 = (L)____________mm
12. Using the average measurement of vertical dimension of relation, measurement L, subtract the tryin’s vertical dimension of occlusion, measurement I, and place the result at “M”
L_______ - I_______ = M________mm
The average mechanically determined inter-occlusal dimension is (M)________mm
Step 4: Determine the candidate’s understanding of jaw relationships
The generally accepted standard for increasing a patient’s vertical dimension of occlusion is 3mm.
Measurement “A” from page 9 determined the patient’s vertical dimension of centric occlusion with their
existing dentures in place
_____A
Measurement “I” from page 11 determined the patient’s vertical dimension of centric occlusion with the
candidate’s try-in in place
_____I
13. Please check if measurement “I” is 3mm (+/- 1mm) greater than “A”
NO
YES
Examiner’s Initials _________
Page 12
College of Denturists of British Columbia
Complete Denture Evaluation Criteria
Version: 072016
Enter the Interocclusal distance that the candidate has proposed in their treatment plan on Line (Q)
Candidate’s proposed IOD = ___________ (Q)
Then, the candidate’s proposed interocclusal distance from the treatment plan, must equal (+/- 1mm)
the actual IOD measurement obtained in “M”
The actual IOD of candidate’s try-in (from “M”) = ___________
14. Please check if measurement “M” is (+/- 1mm) of “Q”
NO
YES
Table O
0
1
IOD is less than 4mm
or
Line 13 is marked NO
or
Line 14 is marked NO
and
excessive milling or adjusting (more than
15% of the occluding surfaces have been
removed)
Measurement I is 3mm greater than A
and
Line 13 is marked YES
and
Line 14 is marked YES
and
less than 15% of the occluding surfaces
have been removed through
milling and or adjusting
Examiner’s Initials _________
Page 13